U.S. patent number 8,939,344 [Application Number 14/161,027] was granted by the patent office on 2015-01-27 for surgical stapling apparatus.
This patent grant is currently assigned to Covidien LP. The grantee listed for this patent is Covidien LP. Invention is credited to Ernest Aranyi, Patrick Mozdzierz, Lee Ann Olson.
United States Patent |
8,939,344 |
Olson , et al. |
January 27, 2015 |
**Please see images for:
( Certificate of Correction ) ** |
Surgical stapling apparatus
Abstract
A loading unit for use with a surgical stapling apparatus is
provided and includes a tool assembly having a cartridge assembly
and an anvil assembly that are movable in relation to one another;
a surgical buttress releasably secured to a tissue contacting
surface of the anvil assembly and/or the cartridge assembly,
wherein each surgical buttress is secured to the anvil assembly
and/or the cartridge assembly by at least one anchor; a release
assembly associated with the anvil assembly and/or the cartridge
assembly; and a drive assembly slidably translatable through the
tool assembly between proximal and distal positions, wherein the
drive assembly actuates the release assembly to thereby release the
anchor to free the surgical buttress from the anvil assembly and/or
the cartridge assembly.
Inventors: |
Olson; Lee Ann (Wallingford,
CT), Aranyi; Ernest (Easton, CT), Mozdzierz; Patrick
(Glastonbury, CT) |
Applicant: |
Name |
City |
State |
Country |
Type |
Covidien LP |
Mansfield |
MA |
US |
|
|
Assignee: |
Covidien LP (Mansfield,
MA)
|
Family
ID: |
42224686 |
Appl.
No.: |
14/161,027 |
Filed: |
January 22, 2014 |
Prior Publication Data
|
|
|
|
Document
Identifier |
Publication Date |
|
US 20140130330 A1 |
May 15, 2014 |
|
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
|
|
13787921 |
Mar 7, 2013 |
8757466 |
|
|
|
13223519 |
Apr 2, 2013 |
8408440 |
|
|
|
12414931 |
Sep 13, 2011 |
8016178 |
|
|
|
Current U.S.
Class: |
227/176.1 |
Current CPC
Class: |
A61B
17/07292 (20130101); A61B 17/07207 (20130101); A61B
17/068 (20130101); A61B 2017/07271 (20130101); A61B
2017/07214 (20130101); Y10T 29/49826 (20150115) |
Current International
Class: |
A61B
17/04 (20060101); A61B 17/10 (20060101) |
Field of
Search: |
;227/175.1-182.1
;606/139,151,154,215,216,219 |
References Cited
[Referenced By]
U.S. Patent Documents
|
|
|
3054406 |
September 1962 |
Usher |
3079606 |
March 1963 |
Bobrov |
3124136 |
March 1964 |
Usher |
3490675 |
January 1970 |
Green |
3499591 |
March 1970 |
Green |
4347847 |
September 1982 |
Usher |
4354628 |
October 1982 |
Green |
4429695 |
February 1984 |
Green |
4452245 |
June 1984 |
Usher |
4605730 |
August 1986 |
Shalaby |
4655221 |
April 1987 |
Devereux |
4834090 |
May 1989 |
Moore |
4838884 |
June 1989 |
Dumican |
4927640 |
May 1990 |
Dahlinder |
4930674 |
June 1990 |
Barak |
5002551 |
March 1991 |
Linsky |
5014899 |
May 1991 |
Presty |
5040715 |
August 1991 |
Green |
5065929 |
November 1991 |
Schulze |
5205459 |
April 1993 |
Brinkerhoff |
5263629 |
November 1993 |
Trumbull |
5307976 |
May 1994 |
Olson |
5312023 |
May 1994 |
Green |
5314471 |
May 1994 |
Brauker |
5318221 |
June 1994 |
Green |
5326013 |
July 1994 |
Green |
5332142 |
July 1994 |
Robinson |
5344454 |
September 1994 |
Clarke |
5392979 |
February 1995 |
Green |
5397324 |
March 1995 |
Carroll |
5425745 |
June 1995 |
Green |
5441193 |
August 1995 |
Gravener |
5441507 |
August 1995 |
Wilk |
5443198 |
August 1995 |
Viola |
5468253 |
November 1995 |
Bezwada |
5503638 |
April 1996 |
Cooper |
5542594 |
August 1996 |
McKean |
5549628 |
August 1996 |
Cooper |
5575803 |
November 1996 |
Cooper |
5653756 |
August 1997 |
Clarke |
5683809 |
November 1997 |
Freeman |
5690675 |
November 1997 |
Sawyer |
5702409 |
December 1997 |
Rayburn |
5752965 |
May 1998 |
Francis |
5762256 |
June 1998 |
Mastri |
5766188 |
June 1998 |
Igaki |
5769892 |
June 1998 |
Kingwell |
5782396 |
July 1998 |
Mastri |
5799857 |
September 1998 |
Robertson |
5810855 |
September 1998 |
Rayburn |
5814057 |
September 1998 |
Oi |
5833695 |
November 1998 |
Yoon |
5843096 |
December 1998 |
Igaki |
5895412 |
April 1999 |
Tucker |
5895415 |
April 1999 |
Chow |
5902312 |
May 1999 |
Frater |
5908427 |
June 1999 |
McKean |
5915616 |
June 1999 |
Viola |
5931847 |
August 1999 |
Bittner |
5964774 |
October 1999 |
McKean |
5997895 |
December 1999 |
Narotam |
6019791 |
February 2000 |
Wood |
6030392 |
February 2000 |
Dakov |
6032849 |
March 2000 |
Mastri |
6045560 |
April 2000 |
McKean |
6063097 |
May 2000 |
Oi |
6080169 |
June 2000 |
Turtel |
6099551 |
August 2000 |
Gabbay |
6149667 |
November 2000 |
Hovland |
6155265 |
December 2000 |
Hammerslag |
6210439 |
April 2001 |
Firmin |
6214020 |
April 2001 |
Mulhauser |
6241139 |
June 2001 |
Milliman |
6258107 |
July 2001 |
Balazs |
6267772 |
July 2001 |
Mulhauser |
6273897 |
August 2001 |
Dalessandro |
6280453 |
August 2001 |
Kugel |
6299631 |
October 2001 |
Shalaby |
6312457 |
November 2001 |
DiMatteo |
6312474 |
November 2001 |
Francis |
6325810 |
December 2001 |
Hamilton |
6436030 |
August 2002 |
Rehil |
6454780 |
September 2002 |
Wallace |
6461368 |
October 2002 |
Fogarty |
6503257 |
January 2003 |
Grant |
6514283 |
February 2003 |
DiMatteo |
6517566 |
February 2003 |
Hovland |
6551356 |
April 2003 |
Rousseau |
6592597 |
July 2003 |
Grant |
6638285 |
October 2003 |
Gabbay |
6652594 |
November 2003 |
Francis |
6656193 |
December 2003 |
Grant |
6669735 |
December 2003 |
Pelissier |
6677258 |
January 2004 |
Carroll |
6685714 |
February 2004 |
Rousseau |
6702828 |
March 2004 |
Whayne |
6704210 |
March 2004 |
Myers |
6723114 |
April 2004 |
Shalaby |
6726706 |
April 2004 |
Dominguez |
6736823 |
May 2004 |
Darois |
6736854 |
May 2004 |
Vadurro |
6746458 |
June 2004 |
Cloud |
6773458 |
August 2004 |
Brauker |
6896684 |
May 2005 |
Monassevitch |
6927315 |
August 2005 |
Heinecke |
6939358 |
September 2005 |
Palacios |
6946196 |
September 2005 |
Foss |
6959851 |
November 2005 |
Heinrich |
7055730 |
June 2006 |
Ehrenfels |
7060087 |
June 2006 |
DiMatteo |
7087065 |
August 2006 |
Ulmsten |
7108701 |
September 2006 |
Evens |
7128253 |
October 2006 |
Mastri |
7128748 |
October 2006 |
Mooradian |
7141055 |
November 2006 |
Abrams |
7147138 |
December 2006 |
Shelton, IV |
7160299 |
January 2007 |
Baily |
7232449 |
June 2007 |
Sharkawy |
7241300 |
July 2007 |
Sharkawy |
7293685 |
November 2007 |
Ehrenfels |
7307031 |
December 2007 |
Carroll |
7311720 |
December 2007 |
Mueller |
7377928 |
May 2008 |
Zubik |
7434717 |
October 2008 |
Shelton, IV |
7438209 |
October 2008 |
Hess |
7547312 |
June 2009 |
Bauman |
7559937 |
July 2009 |
de la Torre |
7594921 |
September 2009 |
Browning |
7604151 |
October 2009 |
Hess |
7665646 |
February 2010 |
Prommersberger |
7666198 |
February 2010 |
Suyker |
7669747 |
March 2010 |
Weisenburgh, II |
7717313 |
May 2010 |
Bettuchi |
7722642 |
May 2010 |
Williamson, IV |
7744627 |
June 2010 |
Orban, III |
7776060 |
August 2010 |
Mooradian |
7793813 |
September 2010 |
Bettuchi |
7799026 |
September 2010 |
Schechter |
7823592 |
November 2010 |
Bettuchi |
7824420 |
November 2010 |
Eldridge |
7845533 |
December 2010 |
Marczyk |
7845536 |
December 2010 |
Viola |
7846149 |
December 2010 |
Jankowski |
7857185 |
December 2010 |
Swayze |
7892247 |
February 2011 |
Conston |
7909224 |
March 2011 |
Prommersberger |
7909837 |
March 2011 |
Crows |
7938307 |
May 2011 |
Bettuchi |
7942890 |
May 2011 |
D'Agostino |
7950561 |
May 2011 |
Aranyi |
7951166 |
May 2011 |
Orban |
7967179 |
June 2011 |
Olson |
7988027 |
August 2011 |
Olson |
8011550 |
September 2011 |
Aranyi |
8011555 |
September 2011 |
Tarinelli |
8016177 |
September 2011 |
Bettuchi |
8016178 |
September 2011 |
Olson |
8028883 |
October 2011 |
Stopek |
8038045 |
October 2011 |
Bettuchi |
8062330 |
November 2011 |
Prommersberger |
8083119 |
December 2011 |
Prommersberger |
8123766 |
February 2012 |
Bauman |
8123767 |
February 2012 |
Bauman |
8146791 |
April 2012 |
Bettuchi |
8157149 |
April 2012 |
Olson |
8157151 |
April 2012 |
Ingmanson |
8167895 |
May 2012 |
D'Agostino |
8192460 |
June 2012 |
Orban |
8210414 |
July 2012 |
Bettuchi |
8225799 |
July 2012 |
Bettuchi |
8225981 |
July 2012 |
Criscuolo |
8231043 |
July 2012 |
Tarinelli |
8235273 |
August 2012 |
Olson |
8245901 |
August 2012 |
Stopek |
8256654 |
September 2012 |
Bettuchi |
8257391 |
September 2012 |
Orban |
8276800 |
October 2012 |
Bettuchi |
8286849 |
October 2012 |
Bettuchi |
8308042 |
November 2012 |
Aranyi |
8308045 |
November 2012 |
Bettuchi |
8308046 |
November 2012 |
Prommersberger |
8312885 |
November 2012 |
Bettuchi |
8313014 |
November 2012 |
Bettuchi |
8348126 |
January 2013 |
Olson |
8348130 |
January 2013 |
Shah et al. |
8365972 |
February 2013 |
Aranyi |
8371491 |
February 2013 |
Huitema |
8371492 |
February 2013 |
Aranyi et al. |
8371493 |
February 2013 |
Aranyi et al. |
8393514 |
March 2013 |
Shelton, IV |
8408440 |
April 2013 |
Olson et al. |
8413871 |
April 2013 |
Racenet |
8424742 |
April 2013 |
Bettuchi |
8453652 |
June 2013 |
Stopek |
8453904 |
June 2013 |
Eskaros |
8453909 |
June 2013 |
Olson |
8453910 |
June 2013 |
Bettuchi |
8464925 |
June 2013 |
Hull |
8474677 |
July 2013 |
Woodard, Jr. |
8479968 |
July 2013 |
Hodgkinson |
8485414 |
July 2013 |
Criscuolo |
8496683 |
July 2013 |
Prommersberger et al. |
8511533 |
August 2013 |
Viola |
8512402 |
August 2013 |
Marczyk |
8529600 |
September 2013 |
Woodard, Jr. |
8540131 |
September 2013 |
Swayze |
8551138 |
October 2013 |
Orban |
8556918 |
October 2013 |
Bauman |
8561873 |
October 2013 |
Ingmanson |
8584920 |
November 2013 |
Hodgkinson |
8590762 |
November 2013 |
Hess |
8616430 |
December 2013 |
Prommersberger |
8631989 |
January 2014 |
Aranyi |
8668129 |
March 2014 |
Olson |
8672206 |
March 2014 |
Aranyi et al. |
8684250 |
April 2014 |
Bettuchi |
8757466 |
June 2014 |
Olson |
8789737 |
July 2014 |
Hodgkinson |
8820606 |
September 2014 |
Hodgkinson |
2002/0028243 |
March 2002 |
Masters |
2002/0091397 |
July 2002 |
Chen |
2003/0065345 |
April 2003 |
Weadock |
2003/0083676 |
May 2003 |
Wallace |
2003/0120284 |
June 2003 |
Palacios |
2003/0181927 |
September 2003 |
Wallace |
2003/0183671 |
October 2003 |
Mooradian |
2003/0208231 |
November 2003 |
Williamson, IV |
2004/0107006 |
June 2004 |
Francis |
2004/0254590 |
December 2004 |
Hoffman |
2004/0260315 |
December 2004 |
Dell |
2005/0002981 |
January 2005 |
Lahtinen |
2005/0021085 |
January 2005 |
Abrams |
2005/0059996 |
March 2005 |
Bauman |
2005/0059997 |
March 2005 |
Bauman |
2005/0070929 |
March 2005 |
Dalessandro |
2005/0118435 |
June 2005 |
DeLucia |
2005/0149073 |
July 2005 |
Arani |
2006/0004407 |
January 2006 |
Hiles |
2006/0135992 |
June 2006 |
Bettuchi |
2006/0173470 |
August 2006 |
Oray |
2006/0178683 |
August 2006 |
Shimoji |
2006/0271104 |
November 2006 |
Viola |
2007/0026031 |
February 2007 |
Bauman |
2007/0034669 |
February 2007 |
de la Torre |
2007/0049953 |
March 2007 |
Shimoji |
2007/0123839 |
May 2007 |
Rousseau |
2007/0179528 |
August 2007 |
Soltz |
2007/0203509 |
August 2007 |
Bettuchi |
2007/0203510 |
August 2007 |
Bettuchi |
2007/0246505 |
October 2007 |
Pace-Floridia |
2008/0029570 |
February 2008 |
Shelton |
2008/0082126 |
April 2008 |
Murray |
2008/0110959 |
May 2008 |
Orban |
2008/0125812 |
May 2008 |
Zubik |
2008/0140115 |
June 2008 |
Stopek |
2008/0161831 |
July 2008 |
Bauman |
2008/0161832 |
July 2008 |
Bauman |
2008/0169327 |
July 2008 |
Shelton |
2008/0169328 |
July 2008 |
Shelton |
2008/0169329 |
July 2008 |
Shelton |
2008/0169330 |
July 2008 |
Shelton |
2008/0169331 |
July 2008 |
Shelton |
2008/0169332 |
July 2008 |
Shelton |
2008/0169333 |
July 2008 |
Shelton |
2008/0200949 |
August 2008 |
Hiles |
2008/0290134 |
November 2008 |
Bettuchi |
2008/0308608 |
December 2008 |
Prommersberger |
2008/0314960 |
December 2008 |
Marczyk |
2009/0001121 |
January 2009 |
Hess |
2009/0001122 |
January 2009 |
Prommersberger |
2009/0001123 |
January 2009 |
Morgan |
2009/0001124 |
January 2009 |
Hess |
2009/0001125 |
January 2009 |
Hess |
2009/0001126 |
January 2009 |
Hess |
2009/0001128 |
January 2009 |
Weisenburgh, II |
2009/0001130 |
January 2009 |
Hess |
2009/0005808 |
January 2009 |
Hess |
2009/0030452 |
January 2009 |
Bauman |
2009/0043334 |
February 2009 |
Bauman |
2009/0076510 |
March 2009 |
Bell |
2009/0076528 |
March 2009 |
Sgro |
2009/0078739 |
March 2009 |
Viola |
2009/0095791 |
April 2009 |
Eskaros |
2009/0095792 |
April 2009 |
Bettuchi |
2009/0120994 |
May 2009 |
Murray |
2009/0134200 |
May 2009 |
Tarinelli |
2009/0206125 |
August 2009 |
Huitema |
2009/0206126 |
August 2009 |
Huitema |
2009/0206139 |
August 2009 |
Hall |
2009/0206141 |
August 2009 |
Huitema |
2009/0206142 |
August 2009 |
Huitema |
2009/0206143 |
August 2009 |
Huitema |
2009/0218384 |
September 2009 |
Aranyi |
2009/0277947 |
November 2009 |
Viola |
2009/0287230 |
November 2009 |
D'Agostino |
2010/0012704 |
January 2010 |
Tarinelli Racenet et al. |
2010/0065606 |
March 2010 |
Stopek |
2010/0065607 |
March 2010 |
Orban, III |
2010/0072254 |
March 2010 |
Aranyi et al. |
2010/0147921 |
June 2010 |
Olson |
2010/0147922 |
June 2010 |
Olson |
2010/0147923 |
June 2010 |
D'Agostino |
2010/0243707 |
September 2010 |
Olson et al. |
2010/0243708 |
September 2010 |
Aranyi et al. |
2010/0243711 |
September 2010 |
Olson et al. |
2010/0249805 |
September 2010 |
Olson et al. |
2010/0264195 |
October 2010 |
Bettuchi |
2010/0282815 |
November 2010 |
Bettuchi |
2011/0024476 |
February 2011 |
Bettuchi |
2011/0024481 |
February 2011 |
Bettuchi |
2011/0036894 |
February 2011 |
Bettuchi |
2011/0042442 |
February 2011 |
Viola |
2011/0046650 |
February 2011 |
Bettuchi |
2011/0057016 |
March 2011 |
Bettuchi |
2011/0087279 |
April 2011 |
Shah et al. |
2011/0215132 |
September 2011 |
Aranyi |
2012/0074199 |
March 2012 |
Olson |
2012/0080336 |
April 2012 |
Shelton |
2012/0187179 |
July 2012 |
Gleiman |
2012/0241499 |
September 2012 |
Baxter |
2012/0273547 |
November 2012 |
Hodgkinson |
2013/0037596 |
February 2013 |
Bear |
2013/0098966 |
April 2013 |
Kostrzewski et al. |
2013/0105548 |
May 2013 |
Hodgkinson |
2013/0105553 |
May 2013 |
Racenet |
2013/0112732 |
May 2013 |
Aranyi et al. |
2013/0112733 |
May 2013 |
Aranyi et al. |
2013/0146641 |
June 2013 |
Shelton |
2013/0153633 |
June 2013 |
Casasanta |
2013/0153634 |
June 2013 |
Carter |
2013/0153635 |
June 2013 |
Hodgkinson |
2013/0153636 |
June 2013 |
Shelton |
2013/0153638 |
June 2013 |
Carter |
2013/0153639 |
June 2013 |
Hodgkinson |
2013/0153640 |
June 2013 |
Hodgkinson |
2013/0153641 |
June 2013 |
Shelton |
2013/0161374 |
June 2013 |
Swayze |
2013/0181031 |
July 2013 |
Olson et al. |
2013/0193186 |
August 2013 |
Racenet |
2013/0193190 |
August 2013 |
Carter |
2013/0193191 |
August 2013 |
Stevenson |
2013/0193192 |
August 2013 |
Casasanta |
2013/0209659 |
August 2013 |
Racenet |
2013/0221062 |
August 2013 |
Hodgkinson |
2013/0240600 |
September 2013 |
Bettuchi |
2013/0240601 |
September 2013 |
Bettuchi |
2013/0240602 |
September 2013 |
Stopek |
2013/0274722 |
October 2013 |
Kostrzewski et al. |
2013/0277411 |
October 2013 |
Hodgkinson |
2013/0306707 |
November 2013 |
Viola |
2013/0310873 |
November 2013 |
Prommersberger |
2013/0327807 |
December 2013 |
Olson |
2014/0012317 |
January 2014 |
Orban |
2014/0021242 |
January 2014 |
Hodgkinson |
2014/0027490 |
January 2014 |
Marczyk |
2014/0034704 |
February 2014 |
Ingmanson |
2014/0048580 |
February 2014 |
Merchant |
2014/0061280 |
March 2014 |
Ingmanson |
2014/0061281 |
March 2014 |
Hodgkinson |
2014/0084042 |
March 2014 |
Stopek |
2014/0097224 |
April 2014 |
Prior |
2014/0117066 |
May 2014 |
Aranyi |
2014/0130330 |
May 2014 |
Olson |
2014/0131418 |
May 2014 |
Kostrzewski |
2014/0131419 |
May 2014 |
Bettuchi |
2014/0138423 |
May 2014 |
Whitfield |
2014/0151431 |
June 2014 |
Hodgkinson |
2014/0155916 |
June 2014 |
Hodgkinson |
2014/0158742 |
June 2014 |
Stopek |
2014/0166721 |
June 2014 |
Stevenson |
2014/0197224 |
July 2014 |
Penna |
2014/0203061 |
July 2014 |
Hodgkinson |
2014/0217147 |
August 2014 |
Milliman |
2014/0217148 |
August 2014 |
Penna |
2014/0239046 |
August 2014 |
Milliman |
2014/0239047 |
August 2014 |
Hodgkinson |
|
Foreign Patent Documents
|
|
|
|
|
|
|
2 667 434 |
|
May 2008 |
|
CA |
|
1 99 24 311 |
|
Nov 2000 |
|
DE |
|
0 594 148 |
|
Apr 1994 |
|
EP |
|
0 327 022 |
|
Apr 1995 |
|
EP |
|
0 667 119 |
|
Aug 1995 |
|
EP |
|
1 064 883 |
|
Jan 2001 |
|
EP |
|
1 256 317 |
|
Nov 2002 |
|
EP |
|
1 256 318 |
|
Nov 2002 |
|
EP |
|
1 520 525 |
|
Apr 2005 |
|
EP |
|
1 621 141 |
|
Feb 2006 |
|
EP |
|
1 702 570 |
|
Sep 2006 |
|
EP |
|
1 759 640 |
|
Mar 2007 |
|
EP |
|
1 815 804 |
|
Aug 2007 |
|
EP |
|
1 825 820 |
|
Aug 2007 |
|
EP |
|
1 929 958 |
|
Jun 2008 |
|
EP |
|
1 994 890 |
|
Nov 2008 |
|
EP |
|
2 005 894 |
|
Dec 2008 |
|
EP |
|
2 005 895 |
|
Dec 2008 |
|
EP |
|
2 008 595 |
|
Dec 2008 |
|
EP |
|
2 090 231 |
|
Aug 2009 |
|
EP |
|
2 090 244 |
|
Aug 2009 |
|
EP |
|
2 090 252 |
|
Aug 2009 |
|
EP |
|
2 198 787 |
|
Jun 2010 |
|
EP |
|
2 236 098 |
|
Oct 2010 |
|
EP |
|
2 236 099 |
|
Oct 2010 |
|
EP |
|
2 311 386 |
|
Apr 2011 |
|
EP |
|
2 436 348 |
|
Apr 2012 |
|
EP |
|
2 462 880 |
|
Jun 2012 |
|
EP |
|
2 517 637 |
|
Oct 2012 |
|
EP |
|
2 586 380 |
|
May 2013 |
|
EP |
|
2 604 195 |
|
Jun 2013 |
|
EP |
|
2 604 197 |
|
Jun 2013 |
|
EP |
|
2 620 106 |
|
Jul 2013 |
|
EP |
|
2 630 922 |
|
Aug 2013 |
|
EP |
|
2 644 125 |
|
Oct 2013 |
|
EP |
|
2000-166933 |
|
Jun 2000 |
|
JP |
|
2002-202213 |
|
Jul 2002 |
|
JP |
|
2007-124166 |
|
May 2007 |
|
JP |
|
WO 90/05489 |
|
May 1990 |
|
WO |
|
WO 95/16221 |
|
Jun 1995 |
|
WO |
|
WO 96/22055 |
|
Jul 1996 |
|
WO |
|
WO 97/01989 |
|
Jan 1997 |
|
WO |
|
WO 97/13463 |
|
Apr 1997 |
|
WO |
|
WO 98/17180 |
|
Apr 1998 |
|
WO |
|
WO 99/45849 |
|
Sep 1999 |
|
WO |
|
WO 03/082126 |
|
Oct 2003 |
|
WO |
|
WO 03/088845 |
|
Oct 2003 |
|
WO |
|
WO 03/094743 |
|
Nov 2003 |
|
WO |
|
WO 03/105698 |
|
Dec 2003 |
|
WO |
|
WO 2005/079675 |
|
Sep 2005 |
|
WO |
|
WO 2006/023578 |
|
Mar 2006 |
|
WO |
|
WO 2006/044490 |
|
Apr 2006 |
|
WO |
|
WO 2006/083748 |
|
Aug 2006 |
|
WO |
|
WO 2007/121579 |
|
Nov 2007 |
|
WO |
|
WO 2008/057281 |
|
May 2008 |
|
WO |
|
WO 2008/109125 |
|
Sep 2008 |
|
WO |
|
WO 2010/075298 |
|
Jul 2010 |
|
WO |
|
WO 2011/143183 |
|
Nov 2011 |
|
WO |
|
WO 2012/044848 |
|
Apr 2012 |
|
WO |
|
Other References
European Search Report corresponding to EP 05 02 2585.3, completed
Jan. 25, 2006 and mailed Feb. 3, 2006; (4 pp). cited by applicant
.
European Search Report corresponding to EP 06 00 4598, completed
Jun. 22, 2006; (2 pp). cited by applicant .
European Search Report corresponding to EP 06 01 6962.0, completed
Jan. 3, 2007 and mailed Jan. 11, 2007; (10 pp). cited by applicant
.
International Search Report corresponding to International
Application No. PCT/US2005/036740, completed Feb. 20, 2007 and
mailed Mar. 23, 2007; (8 pp). cited by applicant .
International Search Report corresponding to International
Application No. PCT/US2007/022713, completed Apr. 21, 2008 and
mailed May 15, 2008; (1 p). cited by applicant .
International Search Report corresponding to International
Application No. PCT/US2008/002981, completed Jun. 9, 2008 and
mailed Jun. 26, 2008; (2 pp). cited by applicant .
European Search Report corresponding to EP 08 25 1779, completed
Jul. 14, 2008 and mailed Jul. 23, 2008; (5 pp). cited by applicant
.
European Search Report corresponding to EP 08 25 1989.3, completed
Mar. 11, 2010 and mailed Mar. 24, 2010; (6 pp). cited by applicant
.
European Search Report corresponding to EP 10 25 0639.1, completed
Jun. 17, 2010 and mailed Jun. 28, 2010; (7 pp). cited by applicant
.
European Search Report corresponding to EP 10 25 0715.9, completed
Jun. 30, 2010 and mailed Jul. 20, 2010; (3 pp). cited by applicant
.
European Search Report corresponding to EP 05 80 4382.9, completed
Oct. 5, 2010 and mailed Oct. 12, 2010; (3 pp). cited by applicant
.
European Search Report corresponding to EP 10 25 1437.9, completed
Nov. 22, 2010 and mailed Dec. 16, 2010; (3 pp). cited by applicant
.
European Search Report corresponding to EP 09 25 2897.5, completed
Feb. 7, 2011 and mailed Feb. 15, 2011; (3 pp). cited by applicant
.
European Search Report corresponding to EP 10 25 0642.5, completed
Mar. 25, 2011 and mailed Apr. 4, 2011; (4 pp). cited by applicant
.
European Search Report corresponding to EP 11 18 8309.6, completed
Dec. 15, 2011 and mailed Jan. 12, 2012; (3 pp). cited by applicant
.
European Search Report corresponding to EP 12 15 2229.6, completed
Feb. 23, 2012 and mailed Mar. 1, 2012; (4 pp). cited by applicant
.
European Search Report corresponding to EP 12 15 0511.9, completed
Apr. 16, 2012 and mailed Apr. 24, 2012; (7 pp). cited by applicant
.
European Search Report corresponding to EP 12 15 2541.4, completed
Apr. 23, 2012 and mailed May 3, 2012; (10 pp). cited by applicant
.
European Search Report corresponding to EP 12 16 5609.4, completed
Jul. 5, 2012 and mailed Jul. 13, 2012; (8 pp). cited by applicant
.
European Search Report corresponding to EP 12 15 8861.0, completed
Jul. 17, 2012 and mailed Jul. 24, 2012; (9 pp). cited by applicant
.
European Search Report corresponding to EP 12 16 5878.5, completed
Jul. 24, 2012 and mailed Aug. 6, 2012; (8 pp). cited by applicant
.
Extended European Search Report corresponding to EP 12 19 1035.0,
completed Jan. 11, 2013 and mailed Jan. 18, 2013; (7 pp). cited by
applicant .
Extended European Search Report corresponding to EP 12 18 6175.1,
completed Jan. 15, 2013 and mailed Jan. 23, 2013; (7 pp). cited by
applicant .
Extended European Search Report corresponding to EP 12 19 1114.3,
completed Jan. 23, 2013 and mailed Jan. 31, 2013; (10 pp). cited by
applicant .
Extended European Search Report corresponding to EP 12 19 2224.9,
completed Mar. 14, 2013 and mailed Mar. 26, 2013; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 12 19 6904.2,
completed Mar. 28, 2013 and mailed Jul. 26, 2013; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 12 19 6911.7,
completed Apr. 18, 2013 and mailed Apr. 24, 2013; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 07 00 5842.5,
completed May 13, 2013 and mailed May 29, 2013; (7 pp). cited by
applicant .
Extended European Search Report corresponding to EP 12 19 8776.2,
completed May 16, 2013 and mailed May 27, 2013; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 12 19 8749.9,
completed May 21, 2013 and mailed May 31, 2013; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 15 6297.7,
completed Jun. 4, 2013 and mailed Jun. 13, 20131; (7 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 17 3985.6,
completed Aug. 19, 2013 and mailed Aug. 28, 2013; (6 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 17 3986.4,
completed Aug. 20, 2013 and mailed Aug. 29, 2013; (6 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 17 7437.4,
completed Sep. 11, 2013 and mailed Sep. 19, 2013; 6 pages. cited by
applicant .
Extended European Search Report corresponding to EP 13 17 7441.6,
completed Sep. 11, 2013 and mailed Sep. 19, 2013; (6 pp). cited by
applicant .
Extended European Search Report corresponding to EP 07 86 1534.1,
completed Sep. 20, 2013 and mailed Sep. 30, 2013; (5 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 18 3876.5,
completed Oct. 14, 2013 and mailed Oct. 24, 2013; (5 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 17 1856.1,
completed Oct. 29, 2013 and mailed Nov. 7, 2013; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 18 0373.6,
completed Oct. 31, 2013 and mailed Nov. 13, 2013; (7 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 18 0881.8,
completed Nov. 5, 2013 and mailed Nov. 14, 2013; (6 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 17 6895.4,
completed Nov. 29, 2013 and mailed Dec. 12, 2013; (5 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 18 2911.1,
completed Dec. 2, 2013 and mailed Dec. 16, 2013; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 10 25 1795.0,
completed Dec. 11, 2013 and mailed Dec. 20, 2013; (6 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 18 7911.6,
completed Jan. 22, 2014 and mailed Jan. 31, 2014; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 08 72 6500.5,
completed Feb. 20, 2014 and mailed Mar. 3, 2014; (7 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 19 5919.9,
completed Feb. 10, 2014 and mailed Mar. 3, 2014; (7 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 19 2123.1,
completed Jan. 30, 2014 and mailed Feb. 10, 2014; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 19 6816.6,
completed Mar. 28, 2014 and mailed Apr. 9, 2014; (9 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 19 4995.0,
completed Jun. 5, 2014 and mailed Jun. 16, 2014; (5 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 19 5019.8,
completed Mar. 14, 2014 and mailed Mar. 24, 2014; (7 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 19 2111.6,
completed Feb. 13, 2014 and mailed Feb. 27, 2014; (10 pp). cited by
applicant .
Extended European Search Report corresponding to EP 13 19 7958.5,
completed Apr. 4, 2014 and mailed Apr. 15, 2014; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 14 15 6342.9,
completed Jul. 22, 2014 and mailed Jul. 29, 2014; (8 pp). cited by
applicant .
Extended European Search Report corresponding to EP 14 15 7195.0,
completed Jun. 5, 2014 and mailed Jun. 18, 2014; (9 pp). cited by
applicant.
|
Primary Examiner: Long; Robert
Parent Case Text
CROSS-REFERENCE TO RELATED APPLICATIONS
The present application is a Continuation application, which claims
the benefit and priority to U.S. patent application Ser. No.
13/787,921, filed on Mar. 7, 2013, which is a Continuation of U.S.
patent application Ser. No. 13/223,519, filed on Sep. 1, 2011, now
U.S. Pat. No. 8,408,440, which is a Continuation of U.S. patent
application Ser. No. 12/414,931, filed on Mar. 31, 2009, now U.S.
Pat. No. 8,016,178, the entire content of each of which being
incorporated herein by reference.
Claims
What is claimed is:
1. A method of attaching a surgical buttress to a surgical
instrument, comprising: providing a surgical instrument including a
cartridge assembly and an anvil assembly; providing at least one
surgical buttress; providing at least one connecting member;
extending the connecting member across the at least one surgical
buttress; and securing the at least one connecting member to a
constricting slot of one of the cartridge assembly and the anvil
assembly.
2. The method of claim 1, further comprising lying the at least one
surgical buttress across a tissue contacting surface of one of the
cartridge assembly and the anvil assembly.
3. The method of claim 1, wherein the constricting slot has a
converging shape.
4. The method of claim 1, wherein at least one of the cartridge
assembly and the anvil assembly has a pair of constricting slots,
and the at least one connecting member has a first and a second
end.
5. The method of claim 4, wherein the first end is secured to a
first of the pair of constricting slots and the second end is
secured to a second of the pair of constricting slots.
6. The method of claim 5, wherein the first of the pair of
constricting slots is wider than the second of the pair of
constricting slots.
7. The method of claim 6, wherein the second end is secured before
the first end.
8. The method of claim 1, wherein the surgical instrument includes
a release assembly.
9. The method of claim 1, wherein the at least one surgical
buttress includes a surgical buttress for the cartridge assembly
and a surgical buttress for the anvil assembly.
10. The method of claim 9, further comprising securing the at least
one connecting member to the constricting slot of the anvil
assembly.
11. A method of attaching a surgical buttress to a surgical
apparatus, comprising: providing a surgical apparatus including a
cartridge assembly and an anvil assembly; providing at least one
surgical buttress; providing at least one fastener; extending the
fastener across the at least one surgical buttress; and securing
the at least one connecting member to a constricting slot of one of
the cartridge assembly and the anvil assembly.
12. The method of claim 11, further comprising lying the at least
one surgical buttress across a tissue contacting surface of one of
the cartridge assembly and the anvil assembly.
13. The method of claim 11, wherein the constricting slot has a
converging shape.
14. The method of claim 11, wherein at least one of the cartridge
assembly and the anvil assembly has a pair of constricting slots,
and the at least one fastener has a first and a second end.
15. The method of claim 14, wherein the first end is secured to a
first of the pair of constricting slots and the second end is
secured to a second of the pair of constricting slots.
16. The method of claim 15, wherein the first of the pair of
constricting slots is wider than the second of the pair of
constricting slots.
17. The method of claim 16, wherein the second end is secured
before the first end.
18. The method of claim 11, wherein the surgical apparatus includes
a release assembly.
19. The method of claim 11, wherein the at least one surgical
buttress includes a surgical buttress for the cartridge assembly
and a surgical buttress for the anvil assembly.
20. The method of claim 19, further comprising securing the at
least one fastener to the constricting slot of the anvil assembly.
Description
BACKGROUND
1. Technical Field
The present disclosure relates to a surgical apparatus having a
buttress material incorporated therewith. More particularly, the
present disclosure relates to a surgical stapling apparatus
including a detachable surgical buttress and/or an endoscopic
surgical stapling apparatus that includes a detachable surgical
buttress.
2. Background of Related Art
Surgical devices for grasping or clamping tissue between opposing
jaw structure and then joining tissue by surgical fasteners are
well known in the art. In some instruments a knife is provided to
cut the tissue which has been joined by the fasteners. The
fasteners are typically in the form of surgical staples but
two-part polymeric fasteners can also be utilized.
Instruments for this purpose can include two elongated jaw members
which are respectively used to capture or clamp tissue. In certain
surgical staplers, one of the jaw members carries a staple
cartridge which houses a plurality of staples arranged in at least
two lateral rows while the other jaw member has an anvil that
defines a surface for forming the staple legs as the staples are
driven from the staple cartridge. The stapling operation is
effected by cam members that travel longitudinally through the
staple cartridge, with the cam members acting upon staple pushers
to sequentially eject the staples from the staple cartridge. A
knife can travel between the staple rows to longitudinally cut
and/or open the stapled tissue between the rows of staples. Such
instruments are disclosed, for example, in U.S. Pat. No. 3,079,606
and U.S. Pat. No. 3,490,675.
Another stapler disclosed in U.S. Pat. No. 3,499,591 also applies a
double row of staples on each side of the incision. This patent
discloses a surgical stapler that has a disposable loading unit in
which a cam member moves through an elongate guide path between two
sets of staggered staple carrying grooves. Staple drive members are
located within the grooves and are positioned in such a manner so
as to be contacted by the longitudinally moving cam member to
effect ejection of the staples from the staple cartridge of the
disposable loading unit. Other examples of such staplers are
disclosed in U.S. Pat. Nos. 4,429,695 and 5,065,929.
Each of the instruments described above is designed for use in
surgical procedures in which surgeons have direct manual access to
the operative site. However, in endoscopic or laparoscopic
procedures, surgery is performed through a small incision or
through a narrow cannula inserted through small entrance wounds in
the skin. In order to address the specific needs of endoscopic
and/or laparoscopic surgical procedures, endoscopic surgical
stapling devices have been developed and are disclosed in, for
example, U.S. Pat. No. 5,040,715 (Green, et al.); U.S. Pat. No.
5,307,976 (Olson, et al.); U.S. Pat. No. 5,312,023 (Green, et al.);
U.S. Pat. No. 5,318,221 (Green, et al.); U.S. Pat. No. 5,326,013
(Green, et al.); U.S. Pat. No. 5,332,142 (Robinson, et al.); and
U.S. Pat. No. 6,241,139 (Milliman et al.), the entire contents of
each of which are hereby incorporated herein by reference.
Tyco Healthcare Group, LP, the assignee of the present application,
has manufactured and marketed endoscopic stapling instruments, such
as the Multifire ENDO GIA.TM. 30 and Multifire ENDO GIA.TM. 60
instruments, for a number of years. These instruments include a
surgical stapling apparatus and a loading unit. Typically, the
loading unit is attached to the apparatus immediately prior to
surgery. After use, the loading unit can be removed from the
apparatus and a new loading unit can be fastened to the apparatus
to perform additional stapling and/or cutting operations. These
instruments have provided significant clinical benefits.
Nonetheless, improvements to these instruments are still
desirable.
When stapling relatively thin or fragile tissues, it is important
to effectively seal the staple line against air or fluid leakage.
Additionally, it is often necessary to reinforce the staple line
against the tissue to prevent tears in the tissue or pulling of the
staples through the tissue. One method of preventing tears or pull
through involves the placement of a biocompatible fabric
reinforcing material, or "buttress" material, between the staple
and the underlying tissue. In this method, a layer of buttress
material is placed against the tissue and the tissue is stapled in
conventional manner. In another method, the buttress material is
positioned on the stapling instrument itself prior to stapling the
tissue. An exemplary example of this is disclosed in U.S. Pat. No.
5,542,594 to McKean et al., the entire content of which is
incorporated herein by reference. In McKean et al., a tube of
buttress material is slipped over the jaw of the stapler. The
stapler is then actuated to staple the subject tissue and secure
the buttress material between the tissue and staple line to
reinforce the tissue and staple line.
SUMMARY
In accordance with the present disclosure a surgical stapling
apparatus is provided including a housing; a handle supported by
the housing; an elongated body extending distally from the housing;
and a tool assembly at the distal end of the elongated body. The
tool assembly has a cartridge assembly including a cartridge having
a plurality of surgical fasteners therein, and an anvil assembly,
wherein at least one of the cartridge assembly and anvil assembly
being movable in relation to the other of the cartridge assembly
and anvil assembly, wherein the anvil assembly includes an anvil
plate, and wherein each of the anvil plate and the staple cartridge
define an elongate longitudinal slot. The surgical stapling
apparatus further includes a surgical buttress releasably secured
to a tissue contacting surface of at least one of the anvil plate
and the staple cartridge, wherein each surgical buttress is secured
to the at least one of the anvil assembly and the cartridge
assembly by at least one anchor; a release assembly associated with
the at least one of the anvil assembly and the cartridge assembly;
and a drive assembly slidably translatable through the tool
assembly from a proximal position to a distal position, wherein the
drive assembly actuates the release assembly to thereby release the
anchor and to free the surgical buttress from the at least one of
the anvil assembly and cartridge assembly.
The release assembly may grip the at least one anchor prior to an
actuation of the drive assembly.
The at least one of the anvil assembly and the cartridge assembly
may define a side slot for receiving an end of the at least one
anchor therein.
The release assembly may include a first bar extending across the
longitudinal slot prior to an actuation of the drive assembly; and
a second bar, connected to and actuatable by the first bar, having
an end extending at least partially into the side slot, prior to an
actuation of the drive assembly.
In use, as the drive assembly is advanced to the distal position,
the drive assembly may actuate the first bar of the release
assembly which in turn may actuate the second bar of the release
assembly to release the anchor disposed within the side slot.
Each of the anvil assembly and the cartridge assembly may include a
release assembly. Each of the anvil assembly and the cartridge
assembly may define a side slot for receiving the anchor of each
surgical buttress.
Each release assembly may include a first bar extending across the
longitudinal slot prior to an actuation of the drive assembly; and
a second bar, connected to and actuatable by the first bar, having
an end extending at least partially into the side slot, prior to an
actuation of the drive assembly. In use, as the drive assembly is
advanced to the distal position, the drive assembly may actuate the
first bar of each release assembly which in turn may actuate the
second bar of each release assembly to release the anchor disposed
within the each side slot.
At least one of the anvil assembly and the cartridge assembly may
include a constricting, open-ended, side slot configured to grip an
end of the anchor, and wherein the release assembly may push the
end of the anchor out of the side slot, upon a distal advancement
of the drive assembly.
The release assembly may include a pusher that is in operative
association with the side slot retaining the end of the anchor. The
pusher may be actuatable by a distally advancing drive member to
push the end of the anchor out of the side slot.
The pusher of the release assembly may be one of pivotally
connected to and slidably supported in at least one of the anvil
assembly and the cartridge assembly.
The anchor may be a suture engaging the surgical buttress and the
at least one of the cartridge assembly and the anvil assembly. The
anchor may be an extension of the surgical buttress and engages the
at least one of the cartridge assembly and the anvil assembly.
According to another aspect of the present application, a loading
unit for use with a surgical stapling apparatus is provided and
includes a tool assembly having a cartridge assembly including a
cartridge having a plurality of surgical fasteners therein, and an
anvil assembly, at least one of the cartridge assembly and the
anvil assembly being movable in relation to the other of the
cartridge assembly and anvil assembly, wherein the anvil assembly
includes an anvil plate and, wherein each of the anvil plate and
the staple cartridge define an elongate longitudinal slot; a
surgical buttress releasably secured to a tissue contacting surface
of at least one of the anvil plate and the staple cartridge,
wherein each surgical buttress is secured to the at least one of
the anvil assembly and the cartridge assembly by at least one
anchor; a release assembly associated with the at least one of the
anvil assembly and the cartridge assembly; and a drive assembly
slidably translatable through the tool assembly from a proximal
position to a distal position, the drive assembly actuating the
release assembly to thereby release the anchor to free the surgical
buttress from the at least one of the anvil assembly and cartridge
assembly.
The release assembly may grip the at least one anchor prior to an
actuation of the drive assembly.
At least one of the anvil assembly and the cartridge assembly may
define a side slot for receiving an end of the at least one anchor
therein.
The release assembly may include a first bar extending across the
longitudinal slot prior to an actuation of the drive assembly; and
a second bar, connected to and actuatable by the first bar, having
an end extending at least partially into the side slot, prior to an
actuation of the drive assembly.
In use, as the drive assembly is advanced to the distal position,
drive assembly actuates the first bar of the release assembly which
in turn actuates the second bar of the release assembly to release
the grip on the end of the at least one anchor disposed within the
side slot.
Each of the anvil assembly and the cartridge assembly may include a
release assembly.
At least one of the anvil assembly and the cartridge assembly may
include a constricting, open-ended, side slot configured to grip an
end of the anchor disposed therein, and wherein the release
assembly may push the end of the anchor out of the side slot, upon
a distal advancement of the drive assembly.
Additional advantages will become apparent from the description
which follows, taken in conjunction with the accompanying
drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
The present disclosure will be further described with reference to
the accompanying drawings, wherein like reference numerals refer to
like parts in the several views, and wherein:
FIG. 1 is a perspective view of a surgical stapling apparatus
according to an embodiment of the present disclosure;
FIG. 2 is a top, perspective view, with parts separated, of a
distal end of a loading unit of the surgical stapling apparatus of
FIG. 1;
FIG. 2A is an enlarged perspective view of a distal end of an anvil
assembly of the loading unit illustrating a surgical anvil buttress
operatively secured to a tissue contacting surface thereof;
FIG. 2B is an enlarged perspective view of a cartridge assembly of
the loading unit illustrating a surgical cartridge buttress secured
to a tissue contacting surface thereof;
FIG. 3 is a top, perspective view of a distal end of an anvil
assembly of the loading unit including a suture release assembly
according to an embodiment of the present disclosure, shown in an
open configuration;
FIG. 4 is a top, perspective view of the anvil assembly of FIG. 3,
illustrating the parts of the suture release assembly thereof
separated;
FIG. 5 is a bottom, perspective view of the anvil assembly of FIGS.
3 and 4;
FIG. 6 is a top, plan view of the anvil assembly of FIGS. 3-5,
illustrating the suture release assembly thereof in the closed
configuration;
FIG. 7 is a top, plan view of the anvil assembly of FIG. 6, with a
retainer removed therefrom;
FIG. 8 is a top, plan view of the anvil assembly of FIGS. 3-7,
illustrating the suture release assembly thereof in the open
configuration;
FIG. 9 is a top, plan view of the anvil assembly of FIG. 8, with a
retainer removed therefrom;
FIG. 10 is a top, perspective view of a distal end of a cartridge
assembly of the DLU including a suture release assembly according
to an embodiment of the present disclosure;
FIG. 11 is a top, perspective view of the cartridge assembly of
FIG. 10, illustrating the parts of the suture release assembly
thereof separated;
FIG. 12 is a bottom, perspective view of a distal end of the
cartridge assembly of FIGS. 10 and 11;
FIG. 13 is a top, plan view of the cartridge assembly of FIGS.
10-12, illustrating the suture release assembly thereof in the
closed configuration;
FIG. 14 is a top, plan view of the cartridge assembly of FIGS.
10-13, illustrating the suture release assembly thereof in the open
configuration;
FIG. 15 is a perspective view of a distal end of a loading unit
including suture release assemblies according to another embodiment
of the present disclosure;
FIG. 16 is an enlarged view of the indicated area of detail of FIG.
15;
FIG. 17 is a top, perspective view of a distal end of an anvil
assembly (with an anvil cover removed), illustrating a suture
release assembly thereof in an actuated configuration;
FIG. 18 is a top, perspective view of the distal end of the anvil
assembly of FIG. 17, illustrating the parts of the suture release
assembly thereof separated;
FIG. 19 is a top, plan view of the anvil assembly of FIGS. 17 and
18, illustrating the suture release assembly thereof in an
unactuated configuration;
FIG. 20 is a top, plan view of the anvil assembly of FIGS. 17-19,
illustrating the suture release assembly thereof in an actuated
configuration;
FIG. 21 is a bottom, perspective view of a distal end of a
cartridge assembly of the DLU of FIG. 15, illustrating a suture
release assembly thereof separated therefrom;
FIG. 22 is a top, perspective view of the suture release assembly
of FIG. 21;
FIG. 23 is a bottom, perspective view, with parts separated, of the
suture release assembly of FIGS. 21 and 22;
FIG. 24 is a top, plan view of the suture release assembly of FIGS.
21-23, illustrating the suture release assembly thereof in an
unactuated configuration;
FIG. 25 is a top, plan view of the suture release assembly of FIGS.
21-24, illustrating the suture release assembly thereof in an
actuated configuration;
FIG. 26 is a top, plan view of a distal end of an anvil assembly of
a loading unit including a suture release assembly according to yet
another embodiment of the present disclosure;
FIG. 27 is a top, perspective view, with parts separated, of the
distal end of the anvil assembly of FIG. 26;
FIG. 28 is a top, plan view of the distal end of the anvil assembly
of FIGS. 26 and 27, illustrating the suture release assembly
thereof in an unactuated configuration;
FIG. 29 is a top, plan view of the distal end of the anvil assembly
of FIGS. 26-28, illustrating the suture release assembly thereof in
an actuated configuration;
FIG. 30 is a top, plan view of a distal end of an anvil assembly of
a loading unit including a suture release assembly according to
still another embodiment of the present disclosure, illustrating
the suture release assembly thereof in an unactuated
configuration;
FIG. 31 is a top, plan view of the distal end of the anvil assembly
of FIG. 30, illustrating the suture release assembly thereof in an
actuated configuration;
FIG. 32 is a top, perspective view of a distal end of a cartridge
assembly of a loading unit including a suture release assembly
according to a further embodiment of the present disclosure;
FIG. 33 is a top, perspective view of the suture release assembly
of FIG. 32;
FIG. 34 is a bottom, perspective view of the suture release
assembly of FIGS. 32 and 33;
FIG. 35 is a bottom, perspective view, with parts separated, of the
suture release assembly of FIGS. 32-34;
FIG. 36 is a top, perspective view, with parts separated, of the
suture release assembly of FIGS. 32-35;
FIG. 37 is a top, plan view of the suture release assembly of FIGS.
32-36, illustrating the suture release assembly in an unactuated
configuration; and
FIG. 38 is a top, plan view of the suture release assembly of FIGS.
32-37, illustrating the suture release assembly in an actuated
configuration.
DETAILED DESCRIPTION OF EMBODIMENTS
Embodiments of the presently disclosed surgical stapling apparatus
and loading unit will now be described in detail with reference to
the drawings, in which like reference numerals designate identical
or corresponding elements in each of the several views.
In the drawings and in the description that follows, the term
"proximal", as is traditional, will refer to the end of the
stapling apparatus which is closest to the operator, while the term
"distal" will refer to the end of the apparatus which is furthest
from the operator.
FIG. 1 shows a surgical apparatus, e.g., surgical stapling
apparatus, generally referred to as 10. In the interest of brevity,
this disclosure will focus primarily on to the tool assembly of the
surgical stapling apparatus 10. A detailed discussion of the
remaining components and method of use of surgical stapling
apparatus 10 is disclosed in U.S. Pat. No. 6,241,139, the
disclosure of which is hereby incorporated by reference herein.
Surgical stapling apparatus 10 is an endoscopic apparatus and
includes a handle assembly 12 and an elongated body 14 extending
from handle assembly 12. A loading unit 16 is releasably secured to
the distal end of elongated body 14. Furthermore, the present
disclosure contemplates surgical stapling apparatus that have a
replaceable cartridge that is received in the jaws of the
apparatus.
Loading unit 16 includes a tool assembly 17 having a cartridge
assembly 18 housing a plurality of surgical fasteners or staples 84
(see FIG. 2) and an anvil assembly 20 secured in juxtaposed
relation relative to cartridge assembly 18, wherein anvil assembly
20 and cartridge assembly 18 are moveable to or away from one
another to close or open tool assembly 17. As shown herein, loading
unit 16 is configured to apply six (6) linear rows of staples, in
loading units measuring from about 30 mm to about 60 mm in length.
Loading units for applying any number of rows of staples, having
staple pockets arranged in various patterns and/or loading units
and end effectors having any other lengths, e.g., 45 mm, are also
envisioned. Handle assembly 12 includes a stationary handle member
22, a movable handle member 24, and a barrel portion 26.
A rotatable member 28 is mounted on the forward end of barrel
portion 26 to facilitate rotation of elongated body 14 and attached
loading unit 16 with respect to handle assembly 12. An articulation
lever 30 is also mounted on the forward end of barrel portion 26
adjacent rotatable member 28 to facilitate articulation of tool
assembly 17. Preferably, a pair of knobs 32 are movably positioned
along barrel portion 26. Knobs 32 are advanced distally to
approximate or close cartridge and/or anvil assembly 18, 20, and
retracted proximally to unapproximate or open cartridge and/or
anvil assembly 18, 20.
Loading unit 16 is desirably selectively removably couplable to
elongated body 14. Loading unit 16 includes a housing portion 36
having a proximal end adapted to releasably engage the distal end
of elongated body 14. A mounting assembly 38 is pivotally secured
at "P" to the distal end of housing portion 36, and is configured
to receive the proximal end of tool assembly 17 such that pivotal
movement of tool assembly 17 about an axis at "P", perpendicular to
the longitudinal axis of housing portion 36, effects articulation
of tool assembly 17.
With general reference to FIG. 2, loading unit 16 includes a
mounting assembly 40. Mounting assembly 40 includes an upper and a
lower mounting portion 40a, 40b, respectively. An axial drive
assembly 50 is operatively associated with and slidably disposed
between cartridge and/or anvil assembly 18, 20. With reference to
FIG. 2, axial drive assembly 50 includes an elongated drive beam 52
having a distal end 54 and a proximal end 56. Drive beam 52 may be
constructed from a single sheet of material or, preferably,
multiple stacked sheets.
Proximal end 56 of drive beam 52 of drive assembly 50 includes a
pair of resilient engagement fingers that receive a pusher. The
pusher is dimensioned and configured to mountingly engage a drive
member, e.g., a drive rod or control rod (not shown) when the
proximal end of loading unit 16 is engaged with elongated body 14
of surgical stapling apparatus 10. The control rod functions to
impart axial movement of drive assembly 50 from handle assembly
12.
Distal end 54 of drive beam 52 of drive assembly 50 includes a head
60 with a laterally extending upper portion 64a, a laterally
extending lower portion 64b, and a central wall portion 62. A
distal edge of central wall portion 62 defines a knife blade or the
like 66.
As seen in FIG. 2, anvil assembly 20 includes an anvil plate 70
having a plurality of staple deforming pockets/cavities (not shown)
and a cover plate 72 secured to a top surface of anvil plate 70,
having a cavity (not shown) is defined therebetween. The cavity
defined between the anvil plate 70 and cover plate 72 is
dimensioned to receive the upper portion 64a of head 60 therein. A
longitudinal slot 70b extends through anvil plate 70 to facilitate
passage of central wall portion 62 of head 60 therethrough.
Additionally, cover plate 72 defines a pair of opposed recesses 72a
formed therein which align with the proximal pair of recesses 70d
formed in anvil plate 70 when cover plate 72 is assembled with
anvil plate 70.
With continued reference to FIG. 2, anvil plate 70 defines a
proximal pair of recesses 70d formed near a proximal end of anvil
plate 70 and disposed, one each, on opposed sides of longitudinal
slot 70b. Anvil plate 70 defines a distal pair of recesses 70e
formed near a distal end of anvil plate 70 and disposed, one each,
on opposed sides of longitudinal slot 70b. In one embodiment, at
least one of the recesses of each of the proximal pair of recesses
70d and the distal pair of recesses 70e is preferably non-circular
and constricting, or has a reduced width dimension, so as to
frictionally engage and/or pinch an anchor "S".
As used herein the term anchor is understood to include and is not
limited to sutures, threads, tethers, straps, bands, lines, wires,
cables, fasteners, tacks or any other material suitable for the
intended purpose disclosed herein. In certain embodiments, the
anchor is an extension of the staple line reinforcement material
discussed below. The anchor may comprise an integral part of the
staple line reinforcement material, or may be formed from the same
or a similar material and attached to the staple line reinforcement
material.
As seen in FIGS. 2 and 2A, anvil assembly 20 further includes a
surgical anvil buttress "B1", pledget or the like operatively
secured to a lower surface or tissue contacting surface of anvil
plate 70, by an anchor "S", to overlie at least some of anvil
pockets 70a and/or at least a portion of a length of longitudinal
slot 70b. In particular, an anchor "S" is wrapped over a proximal
portion of surgical anvil buttress "B1" and cinched in each of the
proximal pair of recesses 70d and an anchor "S" is wrapped around a
distal portion of the surgical anvil buttress "B1" and cinched in
each of the distal pair of recesses 70e.
Surgical anvil buttress "B1" includes a proximal pair of notches
formed in side edges aligned with the proximal pair of recesses 70d
of anvil plate 70, a distal pair of notches formed in side edges
thereof aligned with the distal pair of recesses 70e of anvil plate
70, and a proximal notch formed in a proximal edge thereof aligned
with longitudinal slot 70b when surgical anvil buttress "B1" is
secured to anvil assembly 20. Surgical anvil buttress "B1" further
includes a tongue or tab extending from a distal edge thereof to
facilitate with the attachment of surgical anvil buttress "B1" to
anvil assembly 20 during the assembly process. It is contemplated
that the tongue is removed from surgical anvil buttress "B1"
following securement of surgical anvil buttress "B1" to anvil
assembly 20 and prior to packaging or shipment.
As seen in FIGS. 2-9, anvil assembly 20 further includes a release
assembly 74 disposed between anvil plate 70 and cover plate 72 at a
location in operative registration with the distal pair of recesses
70e. Release assembly 74 includes a guide plate 75 defining an
arcuate slot 75a formed therethrough. Slot 75a is configured and
dimensioned to receive a tool (not shown) therethrough. The
function and purpose of slot 75a will be discussed in greater
detail below.
Release assembly 74 further includes a lock or anchor bar 76
pivotally connected to anvil plate 70 (as seen in FIGS. 4 and 5)
and/or optionally cover plate 72 (shown in FIG. 2). Anchor bar 76
includes a body portion 76a defining an elongate channel or slot
76b therein and a finger 76c extending from an edge thereof. Finger
76c is in operative registration with one of the distal pair of
recesses 70e, preferably, the one of the distal pair of recesses
having the relatively larger width dimension.
Suture release assembly 74 further includes an anchor bar actuation
member 77 pivotally connected to anvil plate 70 (as seen in FIGS. 4
and 5) and/or optionally cover plate 72 (shown in FIG. 2).
Actuation member 77 includes an eccentric cam 77a defining a
central axis of rotation about which actuation member is permitted
to rotate. Actuation member 77 includes a nub or boss 77b extending
from a surface of eccentric cam 77a in a direction substantially
parallel to and offset a radial distance from the central axis of
rotation of eccentric cam 77a. Boss 77b is slidably and rotatably
disposed in elongate slot 76b of anchor bar 76. Actuation member 77
further includes a release bar 77c extending substantially
tangentially from eccentric cam 77a from a side substantially
opposite to boss 77b. Release bar 77c defines a pin 77d formed
thereon which is in registration with the arcuate slot 75a of guide
plate 75. In operation, as eccentric cam 77a is rotated, pin 77d of
release bar 77c follows along the path of arcuate slot 75a of guide
plate 75.
As seen in FIGS. 6 and 7, suture release assembly 74 includes a
locking or anchoring configuration wherein finger 76c of anchor bar
76 extends into or overlies the respective one of the pair of
distal recesses 70e in operative registration therewith, release
bar 77c of actuation member 77 extends across knife slot 70b of
anvil plate 70, and pin 77d of release bar 77c is disposed at or
near a first end of arcuate slot 75a of guide plate 75. It is
contemplated that suture release assembly 74 may include a friction
fit or snap fit feature for maintaining and/or retaining suture
release assembly 74 in the locking or anchoring configuration at
all times following the manufacturing/assembly process and prior to
a complete firing of surgical stapling apparatus 10.
As seen in FIGS. 8 and 9, suture release assembly 74 includes an
open or release configuration wherein finger 76c of anchor bar 76
does not extend into or overlie the respective one of the pair of
distal recesses 70e in operative registration therewith, release
bar 77c of actuation member 77 does not extend across knife slot
70b of anvil plate 70, and pin 77d of release bar 77c is disposed
at or near a second end of arcuate slot 75a of guide plate 75.
Suture release assembly 74 is used by a manufacturer during the
assembly process of surgical stapling apparatus 10 to secure, with
a surgical suture or tether, a surgical anvil buttress "B" to a
tissue contacting surface of the anvil plate 70, and by the end
user of surgical stapling apparatus 10 to automatically release or
free the surgical anvil buttress "B" from the tissue contacting
surface of the anvil plate 70 upon a complete firing of the
surgical stapling apparatus 10.
With reference to FIGS. 6-9, during the manufacturing process, with
suture release assembly 74 in the open or release configuration
(FIGS. 8 and 9), a surgical anvil buttress "B" is laid over the
tissue contacting surface of anvil plate 70. Then, a first end of a
surgical suture "S1" is inserted into one of the pair of distal
recesses 70e and a second end of surgical suture "S1" is extended
across the surgical anvil buttress "B1" (see FIG. 2) and inserted
into the other of the pair of distal recesses 70e. It is
contemplated that the first end of surgical suture "S1" may include
a knot, stop or the like (not shown) sized so as to not pass
through the narrower recess of the distal pair of recesses 70e.
With the second end of the surgical suture "S1" disposed in the
pair of distal recesses 70e, and with the surgical suture "S1"
pulled taught across the surgical anvil buttress "B", a tool (not
shown) is inserted through arcuate slot 75a of guide plate 75 and
engaged with an opening provided in the pin 77d of release bar 77c.
With reference to FIGS. 6 and 7, the tool is then manipulated to
move through or along arcuate slot 75a of guide plate 75, thereby
actuating or moving release bar 77c and rotating eccentric cam 77a.
As eccentric cam 77a is rotated, boss 77b is rotated around the
pivot axis of eccentric cam 77a and acts on the walls of elongate
slot 76b of anchor bar 76 thereby causing anchor bar 76 to pivot.
As anchor bar 76 is pivoted, finger 76c thereof is caused to extend
into or overlies one of the distal recesses 70e and to pinch the
second end of the surgical suture disposed therewithin. Meanwhile,
release bar 77c has been moved to a position extending across knife
slot 70b of anvil plate 70. Suture release assembly 74 is now in
the locking or anchoring configuration, as described above. The
distal recess 70e that cooperates with the finger 76c is desirably
relatively wide so as to allow the suture "S1" to easily pass into
and out of the recess 70e when the 76 anchor bar is away from the
recess 70e. The other distal recess 70e, arranged on the opposite
lateral side of the anvil plate 70, may be the same size, or may be
small enough to cinch the suture "S1" and hold the suture in place
to facilitate assembly.
In operation, with surgical anvil buttress "B1" secured against the
lower surface of anvil plate 70, during firing of surgical stapling
apparatus 10, as drive assembly 50 is advanced (i.e., moved from a
proximal-most position to a distal-most position), knife blade 66
slices through a central section of the proximal suture "S2",
thereby freeing the proximal end of the surgical anvil buttress
"B1" from anvil assembly 20. During use, as the firing stroke of
surgical stapling apparatus 10 is nearing completion and as drive
assembly 50 approaches a distal end of knife slot 70b of anvil
plate 70, as seen in FIG. 9, drive assembly 50 contacts release bar
77c, urging release bar 77c and, in turn, eccentric cam 77a to
rotate about the pivot axis thereof. As eccentric cam 77a is
rotated, boss 77b is rotated around the pivot axis of eccentric cam
77a and acts on the walls of elongate slot 76b of anchor bar 76
thereby causing anchor bar 76 to pivot. As anchor bar 76 is
pivoted, finger 76c thereof is caused to move away from the
relatively wider distal recess 70e and to release the second end of
the surgical suture "S" disposed therewithin. With the second end
of surgical suture "S" released or free, the distal end of the
surgical anvil buttress "B1" is free to separate from the tissue
contacting surface of anvil plate 70.
As seen in FIGS. 1 and 2, cartridge assembly 18 includes a carrier
80 defining an elongated support channel 80a. Elongated support
channel 80a of carrier 80 receives a staple cartridge 82 therein.
Corresponding tabs and slots formed along staple cartridge 82 and
carrier 80 function to retain staple cartridge 82 within carrier
80. A pair of support struts formed on and extending from staple
cartridge 82 are positioned to rest on side walls of carrier 80 to
further stabilize staple cartridge 82 within support channel 80a of
carrier 80. Staple cartridge 82 includes retention slots 82a formed
therein for receiving a plurality of fasteners 84 and pushers 86. A
plurality of spaced apart longitudinal slots 82b extend through
staple cartridge 82 to accommodate upstanding cam wedges 90a of an
actuation sled 90. The actuation sled 90 includes a central
upstanding wedge or wall 90b. Central wall 90b defines a distal
notch or shoulder 90c formed therein (See FIG. 2).
A central longitudinal slot 82c is formed in and extends along the
length of staple cartridge 82 to facilitate passage of central wall
portion 62 of head 60 therethrough. During operation of surgical
stapler 10, actuation sled 90 translates through longitudinal slots
82b of staple cartridge 82 to advance cam wedges 90a into
sequential contact with pushers 92, to cause pushers 92 to
translate vertically within retention slots 82a and urge fasteners
84 (e.g., staples) from slots 82a into the staple forming cavities
70a of anvil plate 70 of anvil assembly 20.
With continued reference to FIGS. 1 and 2, staple cartridge 82
defines a proximal pair of recesses 82e formed near a proximal end
thereof and disposed, one each, on opposed sides of longitudinal
slot 82c. Staple cartridge 82 further defines a distal pair of
recesses 82f formed near a distal end thereof and disposed, one
each, on opposed sides of longitudinal slot 82c. In one embodiment,
at least one of the recesses of each of the proximal pair of
recesses 82e and the distal pair of recesses 82f is preferably
non-circular and constricting or otherwise arranged so as to
frictionally engage and/or pinch an anchor "S".
As seen in FIGS. 1 and 2B, cartridge assembly 18 further includes a
surgical cartridge buttress "B2", pledget or the like operatively
secured to an upper surface or tissue contacting surface of staple
cartridge 82, by anchors "S3" and "S4", to overlie at least some of
staple pockets 82a and/or at least a portion of a length of
longitudinal slot 82c. In particular, an anchor "S4" is wrapped
around a proximal portion of surgical cartridge buttress "B2" and
cinched in each of the proximal pair of recesses 82e and an anchor
"S3" is wrapped around a distal portion of the surgical cartridge
buttress "B2" and cinched in each of the distal pair of recesses
82f.
In one particular embodiment, a first end of each anchor "S"
includes a knot, stop or the like (not shown) sized so as to not
pass through one recess of the proximal pair of recesses 82e and a
second end of each anchor "S" passes over, and transversely across,
surgical cartridge buttress "B2", at least once, and back through
the other recess of the proximal pair of recesses 82e. For example,
the second end of each anchor "S" may be pinched or cinched in the
other recess of the proximal pair of recesses 82e so as to anchor
the second end of the anchor "S" and secure the surgical cartridge
buttress "B2" against the tissue contacting surface of staple
cartridge 82. Similarly, an anchor "S3" is used to extend
transversely across surgical cartridge buttress "B2" and into
engagement with the distal pair of recesses 82f.
In a further embodiment, the release assembly is arranged to cut
the suture "S." The arcuate slot 75a on the guide plate 75 extends
in the opposite direction so that it is arranged to drive the
anchor bar 95 toward the suture "S." The surface of the anchor bar
76 that faces the suture S includes a sharpened edge and cuts the
suture when actuated by the drive assembly.
Surgical cartridge buttress "B2" includes a proximal pair of
notches formed in side edges aligned with the proximal pair of
recesses 82e of staple cartridge 82, a distal pair of notches
formed in side edges thereof aligned with the distal pair of
recesses 82f of staple cartridge 82, and a proximal notch formed in
a proximal edge thereof aligned with longitudinal slot 82c when
surgical cartridge buttress "B2" is secured to staple cartridge 82.
Surgical cartridge buttress "B2" further includes a tongue or tab
extending from a distal edge thereof to facilitate with the
attachment of surgical cartridge buttress "B2" to staple cartridge
82 during the assembly process. It is contemplated that a width of
surgical cartridge buttress "B2" may be reduced in a proximal
portion thereof. It is further contemplated that the tongue is
removed from surgical cartridge buttress "B2" following securement
of surgical cartridge buttress "B2" to staple cartridge 82 and
prior to packaging or shipment.
As seen in FIGS. 2 and 10-14, cartridge assembly 18 further
includes a cartridge release assembly 94 supported in and near a
distal end of staple cartridge 82. Release assembly 94 includes a
lock or anchor bar 95 pivotally connected to staple cartridge 82.
Anchor bar 95 includes a body portion 95a having a finger 95b
extending from an edge thereof. Finger 95b is in operative
registration with one of the distal pair of recesses 82f,
preferably, the one of the distal pair of recesses having the
relatively larger width dimension.
Release assembly 94 further includes an anchor bar actuation member
97 pivotally connected to anchor bar 95 (as seen in FIGS. 11 and
12). Actuation member 97 includes a first cam surface 97a located
along a proximal edge of actuation member 97 and extending across
central longitudinal slot 82c of staple cartridge 82, and a second
eccentric cam surface 97b extending distally and laterally from
actuation member 97 in close proximity to the one of the distal
pair of recesses 82f that is operatively associated with finger 95b
of anchor bar 95. First cam surface 97a of actuation member 97 is
substantially arcuate or convex. Actuation member 97 defines an
aperture or opening 97c configured and dimensioned to receive a pin
95c of anchor bar 95 therein so as to anchor bar 95 and actuation
member 97 to pivot or rotate relative to one another.
In operation, rotation of actuation member 97 in a first direction,
about its pivot point, results in second cam surface 97b pressing
against a surface 82g (see FIGS. 13 and 14) of staple cartridge 82
and thus moving finger 95b at least partially over and/or across
the one of the distal pair of recesses 82f associated
therewith.
As seen in FIG. 13, suture release assembly 94 includes a locking
or anchoring configuration wherein first cam surface 97a of
actuation member 97 extends into and across central longitudinal
slot 82c of staple cartridge 82, wherein second cam surface 97b of
actuation member 97 is pressed against surface 82g of staple
cartridge 82, and thus finger 95b of anchor bar 95 extends into or
overlies the respective one of the pair of distal recesses 82f in
operative registration therewith. Fastener release assembly 94 may
be maintained in the locking or anchoring configuration by way of a
biasing member or a detent that engages actuation member 97 in a
manner so as to keep actuation member 97 in the locked or anchoring
configuration. When in such a locked or anchoring configuration,
the suture "S3" may be urged into recess 82f of staple cartridge
82. It is contemplated that suture release assembly 94 may include
a friction fit or snap fit feature for maintaining and/or retaining
suture release assembly 94 in the locking or anchoring
configuration at all times following the manufacturing/assembly
process and prior to a complete firing of surgical stapling
apparatus 10.
As seen in FIGS. 12 and 14, suture release assembly 94 includes an
open or release configuration wherein finger 95b of anchor bar 95
does not extend into or overlie the respective one of the pair of
distal recesses 82f in operative registration therewith, first cam
surface 97a of actuation member 97 does not extend into and across
central longitudinal slot 82c of staple cartridge 82, and second
cam surface 97b of actuation member 97 is not pressed against
surface 82g of staple cartridge 82.
Suture release assembly 94 is used by a manufacturer during the
assembly process of surgical stapling apparatus 10 to secure, with
an anchor, surgical suture, or tether "S", a surgical cartridge
buttress "B2" (see FIG. 2) to a tissue contacting surface of the
staple cartridge 82, and by the end user of surgical stapling
apparatus 10 to automatically release or free the surgical
cartridge buttress "B2" from the tissue contacting surface of the
staple cartridge 82 upon a complete firing of the surgical stapling
apparatus 10.
With reference to FIGS. 10-14, during the manufacturing process,
with suture release assembly 94 in the open or release
configuration, a surgical cartridge buttress "B2" is laid over the
tissue contacting surface of staple cartridge 82. Then, a first end
of a surgical suture "S" is inserted into the relatively narrower
of the pair of distal recesses 82f and a second end of surgical
suture "S" is extended across the surgical cartridge buttress "B2"
and inserted into the relatively wider of the pair of distal
recesses 82f. It is contemplated that the first end of surgical
suture "S" may include a knot, stop or the like (not shown) sized
so as to not pass through the narrower recess of the distal pair of
recesses 82f.
As seen in FIG. 11, staple cartridge 82 includes an access opening
83 formed therein which is used to insert and receive suture
release assembly 94 therein and to provide access to actuation
member 97. With the second end of the surgical suture "S" disposed
in the relatively wider of the pair of distal recesses 82f, and
with the surgical suture "S" pulled taught across the surgical
cartridge buttress "B2," actuation member 97 is rotated about the
pivot axis causing first cam surface 97a of actuation member 97 to
extend into and across central longitudinal slot 82c of staple
cartridge 82 and causing second cam surface 97b of actuation member
97 to press against surface 82g (see FIGS. 13 and 14) of staple
cartridge 82. In so doing, anchor bar 95 is pivoted by an amount
sufficient for finger 95b of anchor bar 95 to extend into or
overlies the respective one of the pair of distal recesses 82f in
operative registration therewith thereby pinch the second end of
the surgical suture disposed therewithin. Suture release assembly
94 is now in the locking or anchoring configuration, as described
above.
In operation, with surgical cartridge buttress "B1" secured against
the tissue contacting surface of staple cartridge 82, during firing
of surgical stapling apparatus 10, as drive assembly 50 is advanced
(i.e., moved from a proximal-most position to a distal-most
position), knife blade 66 slices through a central section of the
proximal suture "S4", thereby freeing the proximal end of the
surgical cartridge buttress "B2" from staple cartridge 82. During
use, as the firing stroke of surgical stapling apparatus 10 is
nearing completion and as drive assembly 50 approaches a distal end
of central longitudinal slot 82c of staple cartridge 82, as seen in
FIG. 14, drive assembly 50 contacts first cam surface 97a of
actuation member 97, urging actuation member 97 to rotate. Second
cam surface 97b of actuation member 97 also rotates about the pivot
axis of pivot pin 95c thereof. As eccentric second cam surface 97b
is rotated about the pivot axis second cam surface 97b, the
distance between the pivot pin 95c and the surface 82g of staple
cartridge 82 is reduced thereby pivoting anchor bar 95 about pivot
pin 95c. As anchor bar 95 is pivoted, finger 95c thereof is caused
to move away from the relatively wider distal recess 82f and to
release the second end of the surgical suture "S" disposed
therewithin. With the second end of surgical suture "S" released or
free, the distal end of the surgical cartridge buttress "B2" is
free to separate from the tissue contacting surface of staple
cartridge 82. The distal recesses 82f that is in operative
registration with finger 95b of anchor bar 95 is dimensioned so
that, notwithstanding the rotation of anchor bar 95, the suture
"S3" is not cinched therewithin.
As drive assembly 50 is advanced from the proximal position to the
distal position, knife blade 66 thereof slices or cuts
longitudinally through both surgical anvil buttress "B1" and
surgical cartridge buttress "B2", thereby dividing the buttresses
"B1, B2" substantially in half. Additionally, as drive assembly 50
is advanced from a proximal-most position to a distal-most
position, upstanding cam wedges 90a of actuation sled 90 actuates
pushers 92, to cause pushers 92 to translate vertically within
retention slots 82a and urge fasteners 84 from slots 82a. As
fasteners 84 (e.g., staples) are urged from slots 82a of staple
cartridge 82, legs of fasteners 84 penetrate and pass through both
surgical anvil buttress "B1" and surgical cartridge buttress "B2",
through any tissue (not shown) interposed between surgical anvil
buttress "B1" and surgical cartridge buttress "B2", and are formed
against or within staple forming cavities 70a of anvil plate 70 of
anvil assembly 20. Buttresses "B1, B2" preferably include
perforations that divide the buttresses and facilitate removal of
the apparatus from the tissue.
According to the present disclosure, surgical anvil buttress "B1"
and/or surgical cartridge buttress "B2" is pre-loaded (i.e., from
the manufacturer) onto anvil assembly 20 or cartridge assembly 18,
respectively, of the loading unit 16. After the loading unit is
fired, an additional unfired loading unit, with or without
buttresses "B", can be loaded onto the surgical apparatus. In
certain embodiments, the replaceable loading unit is a removable
cartridge that can be inserted into support channel of carrier 80.
A buttress and release assembly may be pre-loaded onto the
removable cartridge and means for the user of the surgical
apparatus to load a buttress onto the anvil assembly can be
provided. For example, a buttress having an adhesive can be used.
Additional or replacement buttresses "B" for anvil assembly 20
and/or cartridge assembly 18 may be secured to either anvil
assembly 20 or cartridge assembly 18 as needed or desired.
In a further embodiment, the release assembly may be arranged to
cut the suture "S." The cam surface 97b on the actuation member 97
may be arranged to cam the anchor bar 95 toward the suture "S." The
surface of the anchor bar 97 that faces the suture "S" may include
a sharpened edge and may cut the suture when actuated by the drive
assembly.
Turning now to FIGS. 15-25, a loading unit according to another
embodiment of the present disclosure, for surgical stapling
apparatus 10, is generally designated as 116. Loading unit 116 is
substantially similar to loading unit 16 and will only be discussed
in detail herein to the extent necessary to identify differences in
construction and operation.
As seen in FIGS. 15-20, anvil assembly 120 of loading unit 116
includes a suture release assembly 174 disposed between anvil plate
170 and cover plate 172 at a location in operative registration
with the distal pair of recesses 170e. Suture release assembly 174
includes a link arm 175 pivotally connected to anvil plate 170 (as
seen in FIG. 18) and/or optionally cover plate 172. Link arm 175
includes a body portion 175a defining a pocket or recess 175c
formed in a first side edge 175b thereof and a camming surface 175d
defined substantially along an adjacent side or proximal edge
thereof. Pocket 175c has a substantially arcuate, circular or
rounded profile. As seen in FIGS. 18 and 20, link arm 175 includes
a pivot pin 175e extending from body portion 175a for pivotally
connecting link arm 175 to anvil assembly 120.
Release assembly 174 further includes a pusher bar 177 pivotally
connected to link arm 175 and slidably disposed between anvil plate
170 and cover plate 172. Pusher bar 177 includes a body portion
177a having a substantially rectangular configuration and a head
177b, extending from a corner of body portion 177a, and having a
substantially circular or rounded configuration. Head 177b of
pusher bar 177 is configured and dimensioned for pivotable and/or
rotatable connection in pocket 175c of link arm 175.
As seen in FIG. 19, suture release assembly 174 includes an
unactuated configuration wherein pusher bar 177 does not extend
into or overlie the respective one of the pair of distal recesses
170e in operative registration therewith, and a longitudinal axis
of link arm 175 is oriented substantially parallel with a
longitudinal axis of loading unit 116. It is contemplated that
suture release assembly 174 may include a friction fit or snap fit
feature for maintaining and/or retaining suture release assembly
174 in the locking or anchoring configuration at all times
following the manufacturing/assembly process and prior to a
complete firing of the surgical stapling apparatus.
As seen in FIG. 20, suture release assembly 174 includes an
actuated configuration wherein pusher bar 177 extends into or
overlies the respective one of the pair of distal recesses 170e in
operative registration therewith, and a longitudinal axis of link
arm 175 is oriented substantially transverse to the longitudinal
axis of loading unit 116.
With reference to FIGS. 15-20, during the manufacturing process,
with suture release assembly 174 in the unactuated configuration, a
surgical anvil buttress (not shown) is laid over the tissue
contacting surface of anvil plate 170. Then, a first end of a
surgical suture "S1" is inserted into one of the pair of distal
recesses 170e and a second end of surgical suture "S1" is extended
across the surgical anvil buttress (not shown) and inserted into
the other of the pair of distal recesses 170e. It is contemplated
that each of the pair of distal recesses 170e is an open ended
constricting slot so as to frictionally grip or cinch a surgical
suture "S1" disposed therein.
In operation, with a surgical anvil buttress (not shown) secured
against the lower surface of anvil plate 170, during firing of the
surgical stapling apparatus, as drive assembly 150 is advanced
(i.e., moved from a proximal-most position to a distal-most
position), knife blade 166 slices through a central section of the
proximal suture (not shown), thereby freeing the proximal end of
the surgical anvil buttress (not shown) from anvil assembly 120.
During use, as the firing stroke of the surgical stapling apparatus
is nearing completion and as drive assembly 150 approaches a
distal-most end of knife slot 170b of anvil plate 170, as seen in
FIG. 20, drive assembly 150 contacts camming surface 175d of link
arm 175, thus urging link arm 175 to rotate or pivot around the
pivot pin and, in turn, urging pusher bar 177 to translate in the
direction of the slot. As pusher bar 177 is translated, pusher bar
177 comes into contact with and urges the second end of suture "S1"
out of the distal recess 170e that is registration therewith to
release the second end of suture "S1" therefrom. With the second
end of surgical suture "S1" released or free from distal recess
170e, the distal end of the surgical anvil buttress "B1" is free to
separate from the tissue contacting surface of anvil plate 170.
As seen in FIGS. 15, 16 and 21-25, cartridge assembly 118 of
loading unit 116 includes a cartridge release assembly 194
supported in and near a distal end of staple cartridge 182. Release
assembly 194 includes a retainer 195 supported in a distal end of
staple cartridge 182 at a location near a distal end of
longitudinal slot 182c and at least partially extending
thereacross. Retainer 195 includes a body portion 195a, a boss 195b
extending from a surface thereof, and defines a channel or recess
195c formed in a surface thereof and extending through a side
thereof. When supported in staple cartridge 182, recess 195c of
retainer 195 is in registration with one of the pair of distal
recesses 182f of staple cartridge 182.
Release assembly 194 further includes a pusher member 196 having a
head portion 196a pivotally connected to boss 195b of retainer 195.
Pusher member 196 further includes a first leg member 196b
extending from head portion 196a and a second leg member 196c
connected to a free end of first leg member 196b via a living hinge
connection 196d. Pusher member 196 further includes piston 196e
connected to a free end of second leg member 196c via a living
hinge connection 196f Piston 196e is slidably disposed and
translatable within recess 195c of retainer 195. In certain other
embodiments, the pusher is a linkage assembly having a first link
pivotably connected to the cartridge at one end. The other end of
the first link is pivotably connected to a first end of a second
link. The opposite, second, end of the second link is confined in
the recess of the retainer.
As seen in FIG. 24, release assembly 194 includes an unactuated
configuration wherein piston 196e does not extend into or overlie
the respective one of the pair of distal recesses 182f, and first
leg member 196b and second leg member 196c are angled with respect
to one another and project proximally along longitudinal slot 182c
of staple cartridge 182. It is contemplated that suture release
assembly 194 may include a friction fit or snap fit feature for
maintaining and/or retaining suture release assembly 194 in the
locking or anchoring configuration at all times following the
manufacturing/assembly process and prior to a complete firing of
the surgical stapling apparatus.
As seen in FIG. 25, suture release assembly 194 includes an
actuated configuration wherein piston 196e extends into or overlies
the respective one of the pair of distal recesses 182f in operative
registration therewith, and first leg member 196b and second leg
member 196c are extended substantially along a common axis.
With reference to FIGS. 21-25, during the manufacturing process,
with suture release assembly 194 in the unactuated configuration, a
surgical cartridge buttress (not shown) is laid over the tissue
contacting surface of staple cartridge 182. Then, a first end of a
surgical suture "S3" is inserted into one of the pair of distal
recesses 182f and a second end of surgical suture "S3" is extended
across the surgical cartridge buttress and inserted into the other
of the pair of distal recesses 182f. It is contemplated that at
least the recess 182f that is adjacent the retainer 195 is an open
ended constricting slot so as to frictionally grip or cinch a
surgical suture "S3" disposed therein.
In operation, with surgical cartridge buttress (not shown) secured
against the tissue contacting surface of staple cartridge 182,
during firing of surgical stapling apparatus 10, as drive assembly
150 is advanced (i.e., moved from a proximal-most position to a
distal-most position), knife blade 166 slices through a central
section of a proximal suture (not shown), thereby freeing the
proximal end of the surgical cartridge buttress from staple
cartridge 182. During use, as the firing stroke of surgical
stapling apparatus 10 is nearing completion and as drive assembly
150 approaches a distal end of central longitudinal slot 182c of
staple cartridge 182, as seen in FIG. 25, drive assembly 150
contacts living hinge connection 196d between first leg member 196b
and second leg member 196c. As drive assembly 150 is further
advanced distally, drive assembly 150 presses against living hinge
connection 196d, causing first leg member 196b and second leg
member 196c to extend. As first leg member 196b and second leg
member 196c extend, piston 196e is translated through recess 195c
of retainer 195. As piston 196e is translated through recess 195c
of retainer 195, piston 196e engages the second end of suture "S3"
and urges suture "S3" out of the distal recess 182f that is
registration therewith to release the second end of suture "S3"
therefrom. With the second end of surgical suture "S3" released or
free from distal recess 182f, the distal end of the surgical
cartridge buttress "B" is free to separate from the tissue
contacting surface of staple cartridge 182.
Turning now to FIGS. 26-29, a loading unit according to another
embodiment of the present disclosure, for surgical stapling
apparatus 10, is generally designated as 216. Loading unit 216 is
substantially similar to loading unit 16 or 116 and will only be
discussed in detail herein to the extent necessary to identify
differences in construction and operation.
As seen in FIGS. 26-29, anvil assembly 220 of loading unit 216
includes a release assembly 274 disposed between anvil plate 270
and cover plate 272 at a location in operative registration with
the distal pair of recesses 270e. Release assembly 274 includes a
cam 275 pivotally connected to anvil plate 270 and/or cover plate
272. Cam 275 includes a body portion 275a having an ovular profile
and defining a cam surface 275b that is in operative association
with one of the distal pair of recesses 270e. Cam 275 further
includes a finger or stem 275c projecting at an angle from a
lateral edge of body portion 275a.
Release assembly 274 further includes a pusher 277 slidably
disposed between anvil plate 270 and cover plate 272. As seen in
FIGS. 27-29, pusher 277 may be slidably disposed within
longitudinal slot 270b of anvil plate 270a. Pusher 277 includes a
cam arm 277a extending substantially in a distal direction. Cam arm
277a is configured and dimensioned to engage and/or act on finger
275c extending from cam 275.
As seen in FIG. 28, suture release assembly 274 includes an
unactuated configuration wherein body portion 275a of cam 275 does
not extend into or overlie the respective one of the pair of distal
recesses 270e in operative registration therewith, and pusher 277
is in a retracted or non-advanced position. As seen in FIG. 28, cam
arm 277a of pusher 277 is adjacent finger 275c and may, although
not necessarily, be in contact with finger 275c of cam 275.
As seen in FIG. 29, suture release assembly 274 includes an
actuated configuration wherein body portion 275a of cam 275 extends
into or overlies the respective one of the pair of distal recesses
270e in operative registration therewith, and pusher 277 is in an
advanced position. As seen in FIG. 29, when pusher 277 is in the
advanced position, cam arm 277a of pusher 277 has engaged finger
275c of cam 275 to rotate body portion 275a of cam 275.
In operation, with an surgical anvil buttress (not shown) secured
against the lower surface of anvil plate 270, during firing of the
surgical stapling apparatus, as drive assembly 250 approaches a
distal-most end of knife slot 270b of anvil plate 270, drive
assembly 250 contacts pusher 277, thus driving pusher 277 distally.
As pusher 277 is driven distally, as seen in FIGS. 28 and 29, cam
arm 277a of pusher 277 engages finger 275c of cam 275 to rotate or
pivot cam 275. As cam 275 is rotated, cam surface 275b of cam 275
comes into contact with and urges the second end of suture "S1" out
of the distal recess 270e that is registration therewith to release
the second end of suture "S1" therefrom. With the second end of
surgical suture "S1" released or free from distal recess 270e, the
distal end of the surgical anvil buttress is free to separate from
the tissue contacting surface of anvil plate 270.
Turning now to FIGS. 30 and 31, a loading unit according to another
embodiment of the present disclosure, for surgical stapling
apparatus 10, is generally designated as 316. Loading unit 316 is
substantially similar to loading unit 16, 116 or 216 and will only
be discussed in detail herein to the extent necessary to identify
differences in construction and operation.
As seen in FIGS. 30 and 31, anvil assembly 320 of loading unit 316
includes a release assembly 374 disposed between anvil plate 370
and the cover plate at a location in operative registration with
the distal pair of recesses 370e. Release assembly 374 includes a
body portion 374a slidably disposed within longitudinal slot 370b
of anvil plate 370a. Release assembly 374 further includes a head
portion 374b connected to or extending from a distal surface of
body portion 374a. Head portion 374b defines a cam surface 374c
along a side edge thereof that is configured and dimensioned for
operatively association with one of the distal pair of recesses
370e formed in anvil plate 370a. Cam surface 374c may have an
arcuate, curved or sinusoidal profile.
As seen in FIG. 30, suture release assembly 374 includes an
unactuated configuration wherein body portion 374a is retracted and
cam surface 374c does not extend into or across the respective one
of the pair of distal recesses 370e in operative registration
therewith.
As seen in FIG. 31, suture release assembly 374 includes an
actuated configuration wherein body portion 374a is advanced
distally and cam surface 374c extends into or overlies the
respective one of the pair of distal recesses 370e in operative
registration therewith.
In operation, with a surgical anvil buttress (not shown) secured
against the lower surface of anvil plate 370, during firing of the
surgical stapling apparatus, as drive assembly 350 approaches a
distal-most end of knife slot 370b of anvil plate 370, as seen in
FIGS. 30 and 31, drive assembly 350 contacts body portion 374a of
release assembly 374, thus driving head portion 374b distally. As
head portion 374b is driven distally, cam surface 374c comes into
contact with and urges the second end of suture "S1" out of the
distal recess 370e that is registration therewith to release the
second end of suture "S1" therefrom. With the second end of
surgical suture "S10" released or free from distal recess 370e, the
distal end of the surgical anvil buttress is free to separate from
the tissue contacting surface of anvil plate 370.
In a further embodiment, the driving head portion may include a
sharpened edge instead of cam surface 374c. As the driving head
portion is moved distally, the suture "S1" is caught between the
sharpened edge of the driving head portion and the side of the
distal recess 370e, severing the suture "S1."
Turning now to FIGS. 32-38, a loading unit according to another
embodiment of the present disclosure, for surgical stapling
apparatus 10, is generally designated as 416. Loading unit 416 is
substantially similar to loading unit 16, 116, 216 or 316 and will
only be discussed in detail herein to the extent necessary to
identify differences in construction and operation.
As seen in FIGS. 32-38, cartridge assembly 418 of loading unit 416
includes a cartridge release assembly 494 supported in and near a
distal end of staple cartridge 482. Release assembly 494 includes a
retainer 495 supported in a distal end of staple cartridge 482 at a
location near a distal end of longitudinal slot 482c and at least
partially extending thereacross. Retainer 495 includes a body
portion 495a, a boss 495b extending from a surface thereof, and
defines a channel or recess 495c formed in a surface thereof and
extending through a side thereof. Body portion 495a of retainer 495
defines a slot 495d formed in opposed sides thereof and which are
configured to receive a suture therein. When supported in staple
cartridge 482, recess 495c of retainer 495 is in registration with
one of the pair of distal recesses 482f of staple cartridge 482,
and slots 495d of retainer 495 are in registration with the pair of
distal recesses 482f of staple cartridge 482 (see FIG. 32).
Release assembly 494 further includes a cam member 496 having a
head portion 496a pivotally connected to boss 495b of retainer 495.
Cam member 496 further includes a body portion 496b extending from
head portion 496a. Body portion 496b defines a first cam surface
496c and a second cam surface 496d each extending substantially
tangentially to an axis of rotation of cam member 496.
Release assembly 494 further includes a sled 497 slidably disposed
within channel 495c of retainer 495. Sled 497 includes a body
portion 497a defining a cam surface 497b oriented to operatively
engage second cam surface 496d of cam member 496, and a side wall
497c in registration with the one of the pair of distal recesses
482f of staple cartridge 482 that is in registration with recess
495c of retainer 495.
As seen in FIG. 37, release assembly 494 includes an unactuated
configuration wherein first cam surface 496c of cam member 496
extends across longitudinal slot 482c staple cartridge 482, side
wall 497c of sled 497 does not extend into or over the one of the
pair of distal recesses 482f of staple cartridge 482 that is in
registration therewith, and second cam surface 496d of cam member
496 is substantially in flush contact with cam surface 497b of sled
497.
As seen in FIG. 38, release assembly 494 includes an actuated
configuration wherein first cam surface 496c of cam member 496 does
not substantially extend across longitudinal slot 482c of staple
cartridge 482, side wall 497c of sled 497 extends into or over the
one of the pair of distal recesses 482f of staple cartridge 482
that is in registration therewith, and second cam surface 496d of
cam member 496 is spaced away from cam surface 497b of sled
497.
With reference to FIGS. 32-38, during the manufacturing process,
with suture release assembly 494 in the unactuated configuration, a
surgical cartridge buttress (not shown) is laid over the tissue
contacting surface of staple cartridge 482. Then, a first end of a
surgical suture "S3" is inserted into one of the pair of distal
recesses 482f and a second end of surgical suture "S3" is extended
across the surgical cartridge buttress and inserted into the other
of the pair of distal recesses 482f. It is contemplated that at
least the distal recesses 482f adjacent the side wall 497c is an
open ended constricting slot so as to frictionally grip or cinch a
surgical suture "S3" disposed therein.
In operation, with a surgical cartridge buttress (not shown)
secured against the tissue contacting surface of staple cartridge
482, during firing of the surgical stapling apparatus, as drive
assembly 450 approaches a distal end of central longitudinal slot
482c of staple cartridge 482, as seen in FIG. 38, drive assembly
450 contacts second cam surface 496c of cam member 496 extending
across longitudinal slot 482c of staple cartridge 482.
As drive assembly 450 is further advanced distally, drive assembly
450 presses against first cam surface 496c of cam member 496,
causing cam member 496 to rotate. As cam member 496 is rotated,
second cam surface 496d thereof contacts and presses against cam
surface 497b of sled 497 thus causing sled 497 to translate in
recess 495c of retainer 495. As sled 497 is translated through
recess 495c, side wall 497c of sled 497 engages the second end of
suture "S3" and urges suture "S3" out of the distal recess 482f
that is registration therewith to release the second end of suture
"S3" therefrom. With the second end of surgical suture "S3"
released or free from distal recess 482f, the distal end of the
surgical cartridge buttress is free to separate from the tissue
contacting surface of staple cartridge 482.
According to further embodiments of the present disclosure, it is
contemplated that buttresses "B" may be provided or formed with
integral wings or tabs extending therefrom for insertion and/or
receipt into distal and/or proximal recesses of anvil assembly
and/or cartridge assembly. It is further contemplated that sutures
"S" may be affixed to, embedded in or other wise connected to
buttresses "B."
Exemplary surgical buttresses "B" for use with the surgical
stapling devices disclosed herein are shown and described in
commonly assigned U.S. Pat. Nos. 5,542,594; 5,908,427; 5,964,774;
6,045,560; 7,823,592; and 7,938,307, the entire contents of each of
which is incorporated herein by reference.
Surgical buttresses "B" may be fabricated from a suitable
biocompatible and bioabsorbable material. Surgical buttresses "B"
may be fabricated from a non-absorbent material which does not
retain fluid. Surgical buttresses "B" may be fabricated from
"BIOSYN" made from GLYCOMER 631 (a block copolymer), a synthetic
polyester composed of glycolide, dioxanone and trimethylene
carbonate.
One block of the resulting copolymer contains randomly combined
units derived from p-dioxanone (1,4-dioxan-2-one) and trimethylene
carbonate (1,3-dioxan-2-one). The second block of the copolymer
contains randomly combined units derived from glycolide and
p-dioxanone. The resulting polyester is an ABA triblock terpolymer
possessing about 60% glycolide, about 14% dioxanone, and about 26%
trimethylene carbonate.
It will be understood that various modifications may be made to the
embodiments disclosed herein. For example, the stapling apparatus
need not apply staples but rather may apply two part fasteners as
is known in the art. Further, the length of the linear row of
staples or fasteners may be modified to meet the requirements of a
particular surgical procedure. Thus, the length of a single stroke
of the actuation shaft and/or the length of the linear row of
staples and/or fasteners within a disposable loading unit may be
varied accordingly. Therefore, the above description should not be
construed as limiting, but merely as exemplifications of preferred
embodiments. Those skilled in the art will envision other
modifications within the scope and spirit of the claims appended
thereto.
* * * * *